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<html>

	<head>
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		<meta name="viewport" content="width=device-width, initial-scale=1,maximum-scale=1,user-scalable=no">
		<meta name="apple-mobile-web-app-capable" content="yes">
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		<title>漳泽农商银行开门红活动</title>
		<style>
			
		</style>
	</head>

	<body style="width:100%;height:100vh;background:url(images/homebg2.png) no-repeat;background-size:100% 100%;overflow-y: auto;box-sizing: border-box;padding-top:25px">
		<div class="banner">
			<h3>*我们承诺对您的信息进行严格保密，仅用于本行活动及邮寄奖品使用!</h3>
			<li class="item">
				<input type="text" placeholder="请输入您的姓名(必填)" name="name">
				<i class="fa fa-user" aria-hidden="true" ></i>
			</li>
			<li class="item">
				<input type="number" placeholder="请输入您的手机号(必填)" name="tel">
				<i class="fa fa-mobile-phone" aria-hidden="true" style="font-size:24px;top:8px"></i>
			</li>
			<li class="item">
				<input type="text" placeholder="请输入您的身份证号(必填)" name="IDCard">
				<i class="fa fa-id-card" aria-hidden="true"></i>
			</li>
			<li class="item">
				<input type="text" placeholder="请输入您的现在住址，为方便邮寄请尽量详细填写(必填)" name="address">
				<i class="fa fa-hospital-o" aria-hidden="true"></i>
			</li>
			<li style="color:rgba(255,255,255,0.8);margin-bottom: 25px;margin-top:-10px;font-size:14px">地址示例：营口小区*号楼*单元***号</li>
			<!--<li class="item">
				<input type="number" placeholder="请输入您的小区楼号,填写数字即可" name="lh">
				<i class="fa fa-hospital-o" aria-hidden="true"></i>
			</li>
			<li class="item">
				<input type="number" placeholder="请输入您的小区单元号,填写数字即可" name="dyh">
				<i class="fa fa-hospital-o" aria-hidden="true"></i>
			</li>
			<li class="item">
				<input type="number" placeholder="请输入您的小区房号,填写数字即可" name="fh">
				<i class="fa fa-university" aria-hidden="true"></i>
			</li>-->
			<div id="tjxx">提交保存</div>
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